The Wizard of Workers' Comp

By Caroline CovingtonPopulation Health ScholarUniversity of Texas SystemMaster's Student in JournalismUT Austin Moody College of Communication

Dr. Ed Bernacki has a knack for finding simple solutions to seemingly complicated problems. When falls and fractures start to balloon at a hospital, Bernacki changes the floor wax to something less slippery. When a contingent of boat enthusiasts starts complaining of back problems at work, his hunch tells him to launch a boating-safety campaign. Bernacki, now a professor of population health at UT Austin's Dell Medical School, has an ability to look beyond the individual to get at the root of workplace injuries. He’s a keen observer of group behavior, and has honed his skills over more than 30 years, enabling him to spot trends in all kinds of workplaces ranging from manufacturing to medicine.

When Bernacki first started working in occupational health in the late 1970s, there was a real need for occupational physicians, especially because manufacturing was booming, and many job injuries happened in labor-intensive industries. Today, despite the steep decline of manufacturing jobs in the U.S., companies still need the expertise of occupational health professionals because every organization assumes financial risk the moment its first employee walks through the door. At Bernacki’s recent post at Johns Hopkins University School of Medicine, in Baltimore, he transformed the way the organization managed that liability. First, healthcare professionals immediately tended to the health of an injured employee – no questions asked. Second, the workers' compensation clinic was on-site at the hospital. Now, Bernacki is bringing this model to Dell Medical School and UT Health Austin, the school’s new clinical practice. Through the WorkLife program at UT Health Austin, Bernacki and his team currently offer workers' compensation and health care services to State of Texas workers, including those from The University of Texas. Future plans include expanding this service to Austin-area businesses.

Bernacki cut his teeth as an occupational health officer in the Air Force, but ended up spending 10 years in the 1980s as a corporate vice president of the multinational conglomerate Tenneco, where he was able to observe workplace health and safety trends on a massive scale. Armed with industry knowledge and a slew of data sets, Bernacki arrived at Johns Hopkins in 1991, and over a period of seven years, he managed to bring down the cost of workers’ compensation claims. Ultimately, he and his team were able to save the organization from $13 million to $17 million annually, mainly by implementing his patient-first philosophy.

“If a person got injured, we would see them immediately and initiate treatment,” he says. “We saw them very frequently so that we could monitor their progress. So anytime a person was ready to come back to work, we knew it and we got ‘em back.”

Bernacki says many of Hopkins' 60,000 employees work within a two-mile radius of the employee clinic. This made it easy to quickly treat injuries like slips and falls—which are common in hospitals—and get employees immediately started on their paperwork. There, once again, he managed to spot simple solutions that made a huge difference to the health of employees and the bottom line, like putting rugs at entry doors during snowstorms.

“When you have a snowstorm and there’s no rugs at the doors, well, people track in snow, it melts and you get slippery surfaces. Every snowstorm, we had a three-, four-hundred-thousand-dollar expense spike in workers' compensation claims because of the fractures,” Bernacki says.

Bernacki says UT Health Austin’s WorkLife will process workplace injuries differently because it will serve companies that are spread across Central Texas, as opposed to being clustered around a central clinic.

“It’s not as easy for us. We have to be a little more clever: telemedicine applications, maybe a booth in a company,” Bernacki says.

Katie Cuevas, operations manager for WorkLife, says she and Bernacki are even thinking of ways to pick up employees to take them to treatment.

There is a demand for a more streamlined approach to workplace injuries, especially at UT-Austin, which has 24,000 employees. In 2018, those employees will be able to use UT Health Austin’s WorkLife clinic for work-related health problems. University employees will also benefit from the program’s prevention initiatives, like ergonomic assessments of work behaviors and referrals to physical therapy.

WorkLife will also offer wellness programs to companies, with an emphasis on preventing or finding diseases early enough to do something about them before they're disabling.

“To keep people well, we’ll have hypertension- and diabetes-detection programs, and all sorts of wellness offerings,” Bernacki says.

Bernacki’s drive to find creative solutions to large-scale health problems hasn’t wavered since the early days of his medical training. He says this latest initiative at Dell Medical School and UT Health Austin is an opportunity to partner with local companies and show them that he can make a difference in the health and safety of their workers, and save money at the same time.

As an occupational physician, though, he sees himself as a bit of an outsider in the medical world. He loves data and finds satisfaction in looking at the big picture of a particular problem.

“Most physicians enjoy treating one patient at a time and are very interested in that whole process,” he says. “I’m interested in that, of course, but I'm also interested in improving the health of an entire population by trying new approaches to disease treatment and prevention, measuring them and seeing how we've made a difference to a lot of people.”